A nurse on a postpartum unit is caring for a group of clients. Which of the following clients is the nurse’s priority?
A client who is 2 days postpartum and whose fundus is 2 to 4 cm below the umbilicus.
A client who is 3 days postpartum and has not had a bowel movement since prior to admission.
A client who is 4 days postpartum and has lochia serosa.
A client who is 1 day postpartum and has not voided in 8 hr.
The Correct Answer is D
A client who is 1 day postpartum and has not voided in 8 hr. This client is at risk of urinary retention, bladder distension, and infection due to the effects of epidural anesthesia, perineal trauma, and fluid shifts after delivery. The nurse should assess the client’s bladder and catheterize if necessary.
Choice A is wrong because a client who is 2 days postpartum and whose fundus is 2 to 4 cm below the umbilicus is showing a normal finding.
The fundus should descend about 1 to 2 cm per day after delivery and be nonpalpable by day 10.
Choice B is wrong because a client who is 3 days postpartum and has not had a bowel movement since prior to admission is not uncommon.
Constipation is a common problem after delivery due to decreased peristalsis, dehydration, and fear of pain.
The nurse should encourage fluid intake, fiber intake, and early ambulation to promote bowel function.
Choice C is wrong because a client who is 4 days postpartum and has lochia serosa is also showing a normal finding.
Lochia serosa is the pinkish-brown discharge that occurs from day 4 to 10 after delivery.
It consists of old blood, serum, leukocytes, and tissue debris.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
This is because the client has hypothyroidism, which means their thyroid gland does not produce enough thyroid hormone. Levothyroxine is a synthetic form of thyroid hormone that can replace the missing hormone and normalize the TSH level. The client’s TSH level is 8.9 mIU/L, which is above the normal range of 0.4 to 4.0 mIU/L. This indicates that the client’s current dosage of levothyroxine is insufficient and needs to be increased.
Choice A is wrong because thyroid ablation therapy is a treatment for hyperthyroidism, not hypothyroidism.
Thyroid ablation therapy involves destroying part or all of the thyroid gland with radioactive iodine or surgery, which reduces the production of thyroid hormone.
This would worsen the client’s condition and symptoms.
Choice C is wrong because lovastatin is a statin drug that lowers cholesterol levels. Hypothyroidism can cause high cholesterol levels, but this is usually corrected by levothyroxine therapy. Replacing lovastatin with cholestyramine, a bile acid sequestrant that also lowers cholesterol levels, would not address the underlying cause of hypothyroidism and would not improve the client’s TSH level.
Choice D is wrong because restricting the intake of iodized salt would not help the client with hypothyroidism. Iodine is an essential element for the synthesis of thyroid hormone, but most people in developed countries get enough iodine from their diet.
Hypothyroidism is usually caused by autoimmune disease, not iodine deficiency.
Correct Answer is ["A","C"]
Explanation
Choice A reason:
The Bradley method teaches the labor partner how to coach and support the mother during labor. This is true because the Bradley method emphasizes the role of the partner as an active participant and a skilled coach who can help the mother relax, breathe, and cope with pain during labor. The partner also serves as an advocate for the mother's preferences and needs in the hospital setting.
Choice B reason:
The Bradley method teaches the mother and partner about the variety of methods to control pain. This is false because the Bradley method does not teach a variety of methods to control pain, but rather focuses on relaxation as the main way to reduce pain during labor. The Bradley method also discourages the use of medication or medical interventions for pain relief, unless they are medically necessary.
Choice C reason:
The Bradley method prepares the woman to deliver without medical interventions and medications. This is true because the Bradley method aims to help women have an unmedicated birth with minimal medical intervention. The Bradley method teaches women how to avoid unnecessary interventions and how to cope with natural labor by using relaxation, breathing, nutrition, and exercise. The Bradley method also educates women on how to reduce their risk of having a C-section and what to do if it becomes medically necessary.
Choice D reason:
The Bradley method focuses on muscle control because muscle tension increases the pain of labor. This is false because the Bradley method does not focus on muscle control, but rather on deep and complete relaxation during labor. The Bradley method believes that muscle tension interferes with the natural process of labor and increases pain, so it teaches women how to relax their muscles and let their bodies do the work.
Choice E reason:
The Bradley method is the most widely used method in the US. This is false because the Bradley method is not the most widely used method in the US, but rather one of several options for natural childbirth. According to a 2017 survey by Listening to Mothers, only 4% of women reported using the Bradley method for their most recent birth, compared to 48% who used Lamaze, 14% who used hypnobirthing, and 9% who used other methods.
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